Intraperitoneal Chemotherapy

Abstract

For the nephrologist, the major therapeutic use of the peritoneal cavity is dialysis, but the peritoneum is a portal of entry for a wide variety of local and systemic therapies. Because of intravenous access problems in neonates, transfusion of packed red blood cells was one of the earliest uses of intraperitoneal (i.p.) therapy [1, 2]. Insulin is often placed in the dialysate in order to treat glucose intolerance during peritoneal dialysis [3], and i.p. insulin delivery is currently undergoing investigation as a means of long-term therapy in diabetes [4-6]. Erythropoietin, prescribed as replacement therapy for the anemia related to end-stage renal disease (ESRD), has been administered intraperitoneally [7, 8]. In contrast to these forms of i.p. therapy, which are designed to treat systemic illnesses, antibacterial agents are injected intraperitoneally in order to treat peritonitis [9]. In the past 20 years, i.p. chemotherapy has increasingly been evaluated for treatment of malignancies localized to the peritoneal cavity [10-29].